OBJECTIVE: In this retrospective study of an elderly population cohort living in a defined Swedish rural area, the relationship between occupation and survival as a measure of objective health was investigated. The cohort has been followed for 25 years. METHOD: On the basis of the baseline socioeconomic interview from assessments performed when the participants were 67 years of age, an index of active participation in daily occupation was devised. The index was used to investigate the covariation between generic everyday occupation and long-time survival. RESULTS: For the female participants, Kaplan-Meier curves demonstrated differences in survival between the &quot;less active&quot; and &quot;more active,&quot; and Cox regression survival analyses resulted in a significant covariance between occupation and survival. For the male participants, no such differences were found. CONCLUSION: The significant results for the women implied support for the core assumption of occupational therapy that a relationship exists between occupation and health. The lack of differences in survival among more active and less active men demonstrates the complexity of studying occupation.

In occupational therapy and occupational science, it is important to clarify the perspective from which the analysis of occupation is addressed. The purpose of this paper is to present a tentative structure for describing occupation, allowing for analysis in a lifelong panorama as well as for the immediate experience a person acquires from performing a single occupation. The concept of occupational value is introduced as a prerequisite for meaning, defining three different dimensions: concrete, symbolic, and self-reward value. A dynamic categorisation of single occupations is presented, considering each unique occupational performance viewed from a macro, meso, and a micro perspective, inspired by dynamic systems theory. It is proposed that all occupations are meaningful if they are integrated parts of a person&#39;s occupational continuity, and that it is the interaction between the mentioned three perspectives that determines their meaningfulness. With an explicit focus on value and meaning as perceived by the unique person, occupational therapists will become more skilled in designing meaningful occupational therapy interventions. This paper is a contribution to the development of occupational science as well as to occupational therapy, but the theoretical framework presented must be empirically tested in order to demonstrate its validity.